Residual gall bladder: An emerging disease after safe cholecystectomy

Vikas Gupta; Anil Kumar Sharma; Pradeep Kumar; Mantavya Gupta; Ajay Gulati; Saroj Kant Sinha; Rakesh Kochhar

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자료유형: 학술저널

저자정보: Vikas Gupta (Postgraduate Institute of Medical Education and Research) Anil Kumar Sharma (Postgraduate Institute of Medical Education and Research) Pradeep Kumar (Postgraduate Institute of Medical Education and Research) Mantavya Gupta (Postgraduate Institute of Medical Education and Research) Ajay Gulati (Postgraduate Institute of Medical Education and Research) Saroj Kant Sinha (Postgraduate Institute of Medical Education and Research) Rakesh Kochhar (Postgraduate Institute of Medical Education and Research)

저널정보: 한국간담췌외과학회 Annals of Hepato-Biliary-Pancreatic Surgery 한국간담췌외과학회지 제23권 제4호

발행연도: 2019.11

수록면: 353 - 358 (6page)

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Backgrounds/Aims: Residual gallbladder mucosa left after subtotal/partial cholecystectomy is prone to develop recurrent lithiasis and become symptomatic, which mandates surgical removal. Methods: we retrospectively evaluated the patients with residual gallbladder referred to us from January 2011 to December 2017. Based on MRCP we classified calot’s anatomy to – type I where cystic duct was seen and type II where sessile GB stump was seen. Results: 21 patients with median age 38 years and M:F::1:9.5, had undergone cholecystectomy (3 months-20 years) prior, presented with recurrent biliary pain. 3 had jaundice (CBD stone, Mirizzi and biliary stricture), 1 had pancreatitis and one had malignancy of the GB. Imaging revealed type I anatomy in 14 (67%) and type II in 7 (33%). All underwent completion cholecystectomy – open in 18 and laparoscopic in 3 (one converted to open). Additional procedure was required in 5 patients – CBD exploration in 2 (10%) and one each Hepatico-jejunostomy, extended cholecystectomy and splenectomy. Median hospital stay was 1 day. There was no mortality and 10% morbidity. One patient with malignancy died at 2 years, two died of unrelated cause, one developed incisional hernia and the remaining were well at a median follow up of 29 months. Conclusions: Residual GB lithiasis should be suspected if there are recurrent symptoms after cholecystectomy. MRCP based proposed classification can guide the management strategy. Completion cholecystectomy is curative.

#Gall bladder #Cholecystectomy #Residual #Cystic duct #Remnant #Recurrent

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Vikas GUPTA

소속기관 TATA Memorial Hospital

주요연구분야 의약학 > 임상의학 > 일반 외과학

논문수 5 이용수 19

Anil Kumar Sharma